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Moles and Freckles and Skin Tags, Oh My!

The past two decades have brought us a significant amount of education on skin cancer: who is at risk, what it looks like, and how to avoid it. Skin cancer is the most common form of cancer in the U.S., with more than 3 million people diagnosed each year. With increased awareness and screening habits, dermatologists are also seeing and treating patients concerned about more benign forms of skin lesions – either for medical reasons or vanity.

“As we grow older and are exposed to more sunlight and environmental factors, our skin changes in response to those exposures,” surgeon Kristi Trimm, DO said. "Almost everyone has at least some presence of skin marks, such as freckles or moles, which may grow, multiply or change over time. While the vast majority of these marks are benign and will never be cancerous, it’s important to give them a closer look at least once every year.”

Below, we break down the list of the most common, non-cancerous skin marks and lesions, and which ones you should pay most attention to over time.

Moles can appear almost anywhere on the skin, either alone or in a group. They are typically brown or black in color, and first appear during childhood or the first 20 years of one’s life. The average adult has between 10 and 40 moles distributed across their body. Over time, moles can change slowly – becoming more raised and lighter in color, developing hairs, or even just disappearing entirely.

Freckles are small brown spots usually found on the face and arms. They are extremely common, often hereditary, and not a health threat.

Skin Tags are a small flap of tissue that hangs off of the skin. They are typically found on the neck, chest, back, armpits, or groin area. Benign and not dangerous, they occur at a higher rate in women. Removal is a common, and mostly painless, procedure.

Lentigines. A lentigo (or plural, lentigines) is a spot that is darker than the surrounding skin. They are typically brown in color, and are more common in Caucasians.

Seborrheic Keratoses are brown or black growths most often found on the chest and back, but also on the head. As they develop, they can appear more warty.

Cherry Angiomas are small, bright red dots, usually ranging in size from a pinpoint to a quarter inch in diameter. Some appear smooth and even with your skin, while others appear slightly raised. They most often grow on the torso, arms, legs and shoulders, and typically show up after age 30.

“With the exception of moles, all of these skin conditions are largely hereditary, are either caused or worsened by sun exposure, and are nearly always benign,” Dr. Trimm said. “Unless the patient is significantly concerned about the aesthetics, or is experiencing bleeding or irritation due to some type of friction, I typically will not recommend any treatment at all for things like freckles or skin tags.”

While moles are also often hereditary, they are more prone to structural changes as you age. Also, moles that are present at birth, and ones that are atypical in size or shape (not perfectly round and flat) are more prone to developing cancerous cells in the future. If a dermatologist believes a mole needs to be evaluated or removed, he or she will first take a biopsy of it. This is a minor procedure resulting in a small tissue sample of the mole that will be examined under a microscope. If any cancerous cells are discovered, the entire mole will be removed along with the rim of normal skin surrounding it. Your physician will most likely want to follow up with you in a matter of weeks, to ensure the small wound is healing properly.

Regardless of family history or a prior cancerous skin lesion, be mindful of all variations and changes in the status of your skin, across all areas of your body. At least every few months, with the help of a mirror and good lighting, examine your face, neck, chest, trunk, and the tops and undersides of your arms and hands. Check the front and backs of your legs and feet, including the soles and areas between your toes. Also check your genital area and the area on and between your buttocks. Have someone help you check your scalp and behind your ears.

See your primary care physician or dermatologist each year and expect them to do a thorough examination of your skin, exploring anything new, changed or irregular. For more information, call (601) 856-1262..

Dr. Trimm is a member of the Medical Staff at Merit Health River Oaks.